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What works in music for wellbeing?
Professor Norma Daykin
Keynote address: ‘Beyond Words Conference’ Privileging the unspoken in arts and communities in a posthuman world.
Plymouth University 14-15th March 2017
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What happens when we play music?
Image by Elizabeth Jane Grose.
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Framing identities: music making in
cancer care.
I enjoyed seeing … instruments from many parts of the
world… and what I like is he left it to us to choose and
pick what we liked, so everybody went round feeling
the instruments, plucking on the strings and choosing
whatever they wanted, whether it was a percussion
instrument or a string instrument or whatever. I really
liked that, I liked the wide diversity and I felt very much
at home. (Al).
Daykin et al. (2007).
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Music in cancer care: themes
• Identity
• Choice and enrichment
• Power, freedom, release
• Healing
• Complex biographies
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Musical Pathways Study
• 118 young people (81 males and 37
females) aged between 13 and 21 years
across eight youth justice sites.
• Interviews (31) and observation.
De Viggiani et al. (2013)
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Musical Pathways study
• 118 young people (81 males and 37
females) aged between 13 and 21
years across eight sites.
• Interviews (31) and observation.
Daykin et al. (2017). In process
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Music as safety
“I’ve learnt to feel more comfortable around
others ... ‘cause people usually tend to be on
edge in this prison. Anything could happen…”
(Fahim, aged 17)
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Distraction
“They treated you like a normal person, not like
a criminal … They were friendly… and, they
brought in quite a few instruments ... They
trusted you as well ...for all they knew, they
could get broken ... They sparked your day,
like … [and] It made you feel like you're
somewhere else.” (Brendan aged 19)
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New horizons
“I liked the way we were using proper
instruments to make a rap / hip hop beat, when
most of the time you’d use software. It’s hands
on, isn’t it? It’s all just human made music. I
love using the software to make songs and
that, but it’s just nice to physically be able to
play an instrument ... I thought those drums
were wicked.’ (Ethan, 18)
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Musical Pathways
• Managing emotions, new experiences,
horizons, enjoyment, learning,
expression, supportive interactions,
pride and achievement.
• Nuanced affordances
• Mediated by context and social
relations
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Mediated affordances (DeNora, 2000; 2003, Daykin et al. 2017)
• Institutional environments
• Gatekeepers
• Musicians
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Musical Pathways: Challenges
• Music can promote wellbeing and
inclusion, and can offer new horizons.
• Music can cause conflict and feelings
of exclusion and failure and can stir
difficult memories and feelings.
• Reflexive skills of music leaders are
critical in shaping successful outcomes.
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Military Wives Choirs Evaluation
Clift, et al. (2014; 2016)
Themes• Identity
• Social connection
• Wellbeing
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Community wellbeing
https://bristolreggaeorchestra.com/
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Music, health and wellbeing:
Research challenges
• Interdisciplinary theories of change
• Research funding
• Frameworks and methods
• Hierarchies of evidence
• Research and advocacy
• Research and evaluation
• Evaluation funding
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http://creativeandcredible.co.uk/
Daykin, N. et al. (2016)
Creative and Credible Evaluation
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Arts for health and wellbeing
An evaluation framework
https://www.gov.uk/government/publications/arts-for-health-and-wellbeing-
an-evaluation-framework
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What Works?
Daykin et al. (2016). https://whatworkswellbeing.org/music-singing/
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Evidence review (Daykin et al. 2016)
• 5,397 papers screened
• 375 full texts assessed
• 61 relevant papers included
• H1 – 39
• H2 – 16
• Dementia – 6
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Music and Singing: What Works?
• Reducing anxiety and improving wellbeing in
young adults.
• Promoting purpose and meaning in healthy adults.
• Reducing stress, negative mood and anxiety in
healthy adult males and females.
• Reducing stress, anxiety and depression in
pregnant women.
• Reducing anger and anxiety in prisoners.
• Learning, connection and meaning in marginalised
groups.
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What works?
• Increasing morale and mental health
related quality of life, reducing
loneliness, anxiety and
preventing/reducing depression in
older people.
• Supporting happiness, connection,
meaning and identity in older people.
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Lower quality evidence - Dementia
• Reducing anxiety and depression.
• Heterogeneous samples.
• Specificity of dementia diagnosis.
• Difficulty of reporting subjective wellbeing
in dementia
Victor et al. 2016. https://whatworkswellbeing.org/music-singing/
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Using participatory music making to improve acute
dementia care in hospital environments: Findings
from evaluation research
Daykin, Walters, et al (2016).
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Music and dementia: study aim
To investigate the impact of a 10 week
participatory music project on the
wellbeing of patients and staff and on the
dementia care environment in an acute
hospital setting.
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The music intervention - up to two
hours of:
• Performance
• Participation
• Familiar repertoire
• Improvisation
• Creative composition
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Mixed methods
• Routine care indicators for 85 patients.
• ArtsObs data for 20 patients
• Qualitative interviews and focus groups
(16).• Ethics approval from the NHS (NRES) Committee
South Central - Hampshire A (REC reference
15/SC/0420) and from the University of Winchester
Research Ethics Committee.
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Quantitative data
Falls; length of stay; staff absences; anti-
psychotic drugs; and one-to-one care
during one of two equivalent ten week
periods:
• Period A = no music,
• Period B = music.
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Quantitative data
• Time A (usual care)
• Data from 38/59 dementia patients
admitted (average age = 80; average
length of stay = 36.9 days)
• Time B (music)
• Data from 47/84 dementia patients
admitted (average age = 91; average
length of stay = 34.68 days)
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Results: Markers of behaviour
Time A (usual care) Time B (Music)
Required one to
one
1 (2.63%) 2 (4.26%)
Required anti-
psychotic drugs
during stay
21 (55.26%) 24 (51.06%)
Prescribed anti-
psychotic drugs on
a Tuesday
17 (44.74%) 8 (17.02%)
Took anti-
psychotic drugs
during stay but not
on a Tuesday
1 (2.63%) 15 (31.91%)
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Markers of behaviour
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Other ward metrics
Time A (usual care) Time B (Music)
Average number
of falls on a
Tuesday
6 7
Total number of
falls
47 31
Staff absences 22 16
Staff absences
on a Tuesday
6 9
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ArtsObs findings
• Mood scores increased for all patients
observed, by between 1 and 3 points
(average 1.6).
• Ratings for relaxation, distraction,
engagement and agitation were
consistently very positive.
• Overall effect of the project on the ward
consistently rated as very positive.
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Qualitative themes
• Engagement
• Enjoyment
• Social benefits
• Positive effects on mood and emotions
• Reminiscence
• Repertoire, preferences and flexibility
• The role of staff
• Hospital organisation.
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Interview data
• I enjoyed the music (male interviewee)
• I like to sing (female interviewee)
• Oh I enjoy it, it’s like going to the pub (male
interviewee)
• It perks me up (male interviewee)
• The singing was good for me (male
interviewee)
• I didn’t enjoy so much the playing (male
interviewee)
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Mediated affordances
Successful outcomes may depend on:
• The skills of music leaders;
• Musical resources, repertoire and
techniques;
• Staff engagement and support;
• Institutional routines, relationships and
imperatives.
• Risks, especially in nonverbal contexts.
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Where next?
• Policy – Cultural Commissioning, PHE
guidelines, APPG.
• Research – ACE, ESRC, AHRC.
• Developing practice.
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References (1/3)
Clift, S. et al. (2014) The Work of the Military Wives Choirs Foundation: An Evaluation. Sidney de Haan Research Centre for Arts and Health.
Clift, S. et al. (2016). The perceived effects of singing on the health and well-being of wives and partners of members of the British Armed Forces: a cross-sectional survey, Public Health, 138: 93-100.
Daykin, N. et al. (2007). Creativity, identity and healing: participants’ accounts of music therapy in cancer care. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 11, (3), 349-370.
Daykin, N. & Feldtkeller, B. (2009) Arts @ Callington Rd, Project Evaluation. Report for Avon and Wiltshire Mental Health Partnership NHS Trust and Bristol City Council. Bristol: University of the West of England.
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References (2/3)
Daykin, N. with Joss, T. (2016) Arts for Health and Wellbeing: An Evaluation Framework. Public Health England. February 2016. Available from:
https://www.gov.uk/government/publications/arts-for-health-and-wellbeing-an-evaluation-framework
Daykin, N. et al. (2016) Creative and credible evaluation for arts, health and wellbeing: Opportunities and challenges of coproduction. Arts and Health. 26 Sept 2016.Victor et al. 2016. Music, singing and wellbeing for adults withdementia. A Systematic Review. https://whatworkswellbeing.org/music-singing/Daykin et al. (2016). Music, singing and wellbeing in healthyadults: A systematic review. https://whatworkswellbeing.org/music-singing/
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References (3/3)
Daykin, N. et al. (2016). Arts and Dementia: Using Participatory Music Making to Improve Acute Dementia Care in Hospital Environments: An Exploratory Study. University of Winchester.
DeNora, T. (2000) Music in Everyday Life, Cambridge: Cambridge University Press.
DeNora, T. (2003) After Adorno: Rethinking Music Sociology, Cambridge, United Kingdom: Cambridge University Press, 2003.
De Viggiani, N. et al. (2013) An exploratory study of young people in the Criminal Justice System engaged with a creative music programme. UWE, Bristol.
Daykin, N et al. (2017) Music making for health and wellbeing in youth justice settings: mediated affordances and the impact of context and social relations. Sociology of Health and Illness, Volume 39 issue 6, July 2017. In process